White L M, Schweitzer M E, Deely D M, Gannon F
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Radiology. 1995 Dec;197(3):840-2. doi: 10.1148/radiology.197.3.7480765.
To determine the utility of combined histologic and microbiologic evaluation of percutaneous biopsy samples in cases of suspected osteomyelitis.
Twenty-five patients with suspected osteomyelitis were prospectively studied over a 1-year period. With usual trephine techniques under radiologic guidance, core and aspiration biopsy samples were obtained in each patient for both histologic and microbiologic analyses.
Sixteen biopsy specimens demonstrated histologic evidence of osteomyelitis. Of these, eight were also culture positive. Seven of the eight culture-negative, histologically positive cases were interpreted as chronic osteomyelitis. In no patient were cultures positive and histologic findings negative. Three of 19 patients with proved osteomyelitis had negative histologic and microbiologic findings. The sensitivity of culture in the diagnosis of osteomyelitis in our study was 42%; the sensitivity of both culture and histologic findings was 84%.
Although the volume of a biopsy specimen is a major determinant of culture yield, a portion of a percutaneous biopsy sample should be histologically evaluated for possible osteomyelitis.
确定在疑似骨髓炎病例中，经皮活检样本的组织学和微生物学联合评估的效用。
对25例疑似骨髓炎患者进行了为期1年的前瞻性研究。在放射学引导下，采用常规环钻技术，为每位患者获取芯针活检和穿刺活检样本，用于组织学和微生物学分析。
16份活检标本显示有骨髓炎的组织学证据。其中，8份标本培养结果也呈阳性。8份培养阴性但组织学阳性的病例中，有7例被诊断为慢性骨髓炎。没有患者培养结果呈阳性而组织学检查结果为阴性。19例确诊骨髓炎的患者中，有3例组织学和微生物学检查结果均为阴性。在我们的研究中，培养法诊断骨髓炎的敏感性为42%；培养和组织学检查结果的敏感性为84%。
尽管活检样本的量是培养结果的主要决定因素，但对于可能的骨髓炎，经皮活检样本的一部分应进行组织学评估。
